Emergency Rooms With a View

By Larry Teren

Recent circumstances caused me to become an informed critic of Hospital Emergency Rooms and health care. Ma had the misfortune to visit two of them in one week. The hospitals were located about three and a half miles apart along the same major road in north suburban Chicago.

The short part of the story is that Ma and I were brought by ambulance to Hospital A’s emergency room a week ago Friday night at 1:45am. She was experiencing severe abdominal pain. She begged for morphine several times but was denied any type of relief until they had a modicum of an idea what was wrong with her. However, they did not bother to try to find out until they took a CT Scan at around 5am. Exactly- we were at the mercy of the hospital personnel for more than three hours.

A few things did not help the situation. One was that the hospital did not have ma in their new medical records system. The idiots had two months earlier switched from one medical records system to another but have not transferred patient information. So, when a previous patient came to the hospital, the medical records person would have to try to poke into another system that was difficult to bring up on their computer screen, and then write it down on paper and then manually input the medical records into the new system. Great health care, huh?

Another was that Ma was given cubicle room number 1 which was near the front electric doors that seemed to swing open every few minutes with a new calamity. It made the environs both cold (weather-wise) and noisy. Around 4am or so (it’s hard to get all the facts straight when you are trying to sleep with your eyes open and sitting in a chair) a single mom and her twenty year old daughter were seated outside Ma’s curtained-off room. The lady proceeded to talk her head off lecturing to her daughter about the evils of going to parties at other people’s houses when you don’t know them. The lecture was orated a little too loud as well as it went on for quite a while. Being that is was inappropriate for the mother to start shouting about her daughter’s welfare in a public area as well as it was getting close to 5am, I drew open the curtain, and in a somewhat considerate tone (yeah, sure) , told the mother to “move somewhere else or shut up”.

It took less than fifteen minutes to wheel Ma to some magical location in the building to do the CT Scan and bring her back to where I sat in a stupor after being awake for more than twenty-two hours. Fifteen minutes later, I pestered the Emergency Room doctor as to whether someone actually bothered to look at the ct scan and make a decision. She told me that the attending physician we had requested was being contacted and would decide whether to admit Ma or not.

By 7am, we got the good (?) news that Ma would be admitted upstairs to try to figure out what was wrong with her. Now, it was a matter of hurry up and wait for a bed to become available. I threw a tantrum at 8:45am and a nurse volunteered to wheel Ma upstairs.

For three days, the yokels at hospital A could not figure out the cause of Ma’s pain nor were they willing to check with her regular doctor associated with a different hospital chain for her medical history. While I was in a business meeting on Tuesday, Ma called me to say that the Resident doctor told her that they were releasing her because she was not getting better nor could they figure out what her problem was. The so-called medical expert suggested that she follow up with another CT Scan in two to three months. Still, she was in severe pain and could not stand on her two feet. But, that wasn’t their problem- it was not a medical issue, it was a ‘social’ issue. Translated, it meant that Medicare would not cover her for any more hospitalization. So, they wanted her to get lost. She had a choice to either go home or to a nursing care facility that Medicare would cover for up to 20 days only because she spent the requisite three days in a hospital. I subsequently found out that “hospital stay” meant that it had to be in the category of ‘inpatient status’ and not ‘observation’. Although, come on, who is kept in a hospital for three days for just observation? Otherwise, Medicare would not cover her getting well at a nursing care facility. Great health care system, huh?

I asked them to get her transferred to the hospital associated with her real doctor. They said they could not because she had already spent three days in this one and it would require a new case number in order for Medicare to cover it. The other hospital would not take her in a transfer. But, they would if she went to their emergency room. Aha! Great health care laws, huh?

Wednesday morning we left the bad guys hideout and drove down the road another three miles or so to Hospital B. It was a different experience going to their Emergency Room as I rolled Ma in on her wheelchair to the registration area as opposed to being brought in by ambulance. At Hospital B, we were asked to sit down and relax and were almost immediately greeted by a nurse in the lobby area. She escorted us into the Emergency Room theater of operations and asked the Maitre D’, I mean, physician’s assistant to assign her a room as if she had a reservation.

(In the interest of fair reporting, it should be noted that this hospital is where does most of her business and IS in their medical records system.)

Once in our comfy cubbyhole, I was asked if I cared for a drink. Instead, I asked for the washroom. After given directions and taking advantage of its availability, I made note that it had a lock on the door as opposed to Hospital A which did not and which probably caused- I’m sure- awkward moments.

At Hospital B we spent ‘only’ six hours in the emergency room this time instead of the seven and half hours we experienced at Hospital A. The transfer to a room upstairs went more smoothly and by the next morning, the diligence of the two resident interns as well as “hospitalist” resolved Ma’s mysterious condition.They had reviewed the ct scan digital files I was given from the other hospital. They didn’t see the need to do another ct scan and wondered why they proscribed a certain type of antibiotic.

They said she had a virus as well as an infection. They changed the type of antibiotic that the other hospital had recommended and she started to improve immediately. By 6pm, she was on her way to a rehab facility to recover and get back on her feet. Now, this is good health care, huh?

I cannot prove one way or the other, but I wonder if both hospitals would have let her stay longer if she was not covered by medicare but rather private medical insurance. Like it or not, this is the way our health care is going to be doled out.